Medicare Part D coverage · podofilox · RxCUI 312466
podofilox 0.005 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, podofilox 0.005 MG/MG Topical Gel is covered by 141 Medicare Part D plans (2.8% of enrollable products), averaging Tier 3.2, with prior authorization required on 0% of covering formularies.
- 2.8%
- Plan coverage
- 141
- Plans covering
- T3.2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for podofilox 0.005 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, podofilox 0.005 MG/MG Topical Gel (RxNorm concept RXCUI 312466, generic name podofilox) appears on 17 distinct formulary files spanning 141 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to podofilox 0.005 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,737 Part D beneficiaries filled podofilox 0.005 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $348,510 and an average per-beneficiary annual cost of $93.26. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry podofilox 0.005 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 17
- Plans covering
- 141
- Coverage rate
- 2.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,737
- Total spending
- $348,510
- Avg per beneficiary
- $93.26
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering podofilox 0.005 MG/MG Topical Gel
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
Show the next 30 plans
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is podofilox 0.005 MG/MG Topical Gel covered by Medicare Part D?
Yes, podofilox 0.005 MG/MG Topical Gel is covered by 141 Medicare Part D plans (2.8% of all Part D formularies).
What tier is podofilox 0.005 MG/MG Topical Gel on Medicare Part D plans?
podofilox 0.005 MG/MG Topical Gel averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does podofilox 0.005 MG/MG Topical Gel require prior authorization?
0% of Part D formularies require prior authorization for podofilox 0.005 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on podofilox 0.005 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on podofilox 0.005 MG/MG Topical Gel was $348,510, covering 3,737 beneficiaries. The average spend per beneficiary was $93.26.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- clobetasol propionate 0.5 MG/ML Medicated Shampoo [Clodan] T3.2
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- fluorometholone 2.5 MG/ML Ophthalmic Suspension [FML Forte Liquifilm] T3.2
- 0.5 ML filgrastim-ayow 0.6 MG/ML Prefilled Syringe [Releuko] T3.2
- 0.8 ML filgrastim-ayow 0.6 MG/ML Prefilled Syringe [Releuko] T3.2
- levetiracetam 500 MG Tablet for Oral Suspension T3.2